THE INFLUENCE OF CHEMOTHERAPY ON RENAL TUBERCULOSIS THE INFLUENCE ON RENAL FUNCTION AND THE RELATION BETWEEN RENAL FUNCTION AND LIVER FUNCTION AND BLOOD PRESSURE
1961 Volume 52 Issue 7 Pages 612-629
Details
1961 Volume 52 Issue 7 Pages 612-629
The author classified 157 cases of renal tuberculosis, whose renal functions could be examined before and after chemotherapy, into group I, 106 cases of nephrectomy and chemotherapy, group II, 51 cases of chemotherapy only, and group III, 20 cases of nephrectomy only. These 51 cases belonged to group II were further classified into:—(a) 14 cases of unilateral renal tuberculosis, (b) 20 cases of bilateral one, and (c) 17 cases of tuberculosis of the remaining kidney after nephretomy. As the control group, 34 cases of non-tuberculous renal diseases and 15 cases of nephritis were collected. These cases of chomotherapy, chiefly by SM, were also devided into four groups according to dosage: less than 15g, 16-30g, 31-60g and more than 60g. The examination of renal functions was done through the test of indigocarmin excretion, the concentration and dilution test, PSP test, NPN and urea clearance.
The results obtained were as follows:
1) The improvement of renal functions in the nephrectomy group (including the cases with combined use of chemotherapy) was more favourable than in the chemotherapy group except in the NPN.
2) The relations between the improvement of renal functions and the dosage of SM (as stated above) were as follows:
a) Indigocarmin excretion test showed that the dosage of 30g SM gave the highest proportion of improvement in groups I and II (a) and (b) and that a higher dosage seemed to have nothing to do with the improvement of the renal function. However, in the cases of tuberculosis of the remaining kidney, a dosage of 60g showed a higher percentage of improvement.
b) The same tendency as showed in (a) was observed in the concentration and dilution test, PSP test, NPN and urea clearance. Generally, these tests showed that a greater dosage of SM seemed to be required for the improvement of renal functions than that showed in the concentration and dilution test.
3) The correlation between urea clearance and other tests before and after the use of SM: There was significant correlation between the concentration and dilution test and urea clearance except in group I, but even in the cases of group I there was significant correlation after medical treatment, In groups I and II (a), there was not so close a correlaton with PSP test before and after treatment. Significant inverse correlation with NPN before and after treatment was shown in group II, and the same is the case with group I and II after treatment,
4) The functions of liver and kidney were so closely connected that they often run parallel to each other.
In cases of impediment to both liver and renal functions, it was revealed that the improvement of liver functions might take place later than that of renal functions.
5) The relation with biood pressure: In the cases of nephrectomy (including the case with combined chemotherapy), the cases of falling blood pressure just after treatment were more frequently encountered than in the cases of chemotherapy only. In each group, as time went on after the treatment, the cases of rising blood pressure gradually increased in number, and those of falling blood pressure decreased.
6) Through this observation of renal function, it was reaffirmed that all the cases of renal tuberculosis could not be cured by chemotherapy alone, at least for the time being.
